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Bol KF, Schreibelt G, Bloemendal M, van Willigen WW, Hins-de Bree S, de Goede AL, de Boer AJ, Bos KJH, Duiveman-de Boer T, Olde Nordkamp MAM, van Oorschot TGM, Popelier CJ, Pots JM, Scharenborg NM, van de Rakt MWMM, de Ruiter V, van Meeteren WS, van Rossum MM, Croockewit SJ, Koeneman BJ, Creemers JHA, Wortel IMN, Angerer C, Brüning M, Petry K, Dzionek A, van der Veldt AA, van Grünhagen DJ, Werner JEM, Bonenkamp JJ, Haanen JBAG, Boers-Sonderen MJ, Koornstra RHT, Boomsma MF, Aarntzen EHJ, Gotthardt M, Nagarajah J, de Witte TJM, Figdor CG, de Wilt JHW, Textor J, de Groot JWB, Gerritsen WR, de Vries IJM. Adjuvant dendritic cell therapy in stage IIIB/C melanoma: the MIND-DC randomized phase III trial. Nat Commun 2024; 15:1632. [PMID: 38395969 PMCID: PMC10891118 DOI: 10.1038/s41467-024-45358-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Autologous natural dendritic cells (nDCs) treatment can induce tumor-specific immune responses and clinical responses in cancer patients. In this phase III clinical trial (NCT02993315), 148 patients with resected stage IIIB/C melanoma were randomized to adjuvant treatment with nDCs (n = 99) or placebo (n = 49). Active treatment consisted of intranodally injected autologous CD1c+ conventional and plasmacytoid DCs loaded with tumor antigens. The primary endpoint was the 2-year recurrence-free survival (RFS) rate, whereas the secondary endpoints included median RFS, 2-year and median overall survival, adverse event profile, and immunological response The 2-year RFS rate was 36.8% in the nDC treatment group and 46.9% in the control group (p = 0.31). Median RFS was 12.7 months vs 19.9 months, respectively (hazard ratio 1.25; 90% CI: 0.88-1.79; p = 0.29). Median overall survival was not reached in both treatment groups (hazard ratio 1.32; 90% CI: 0.73-2.38; p = 0.44). Grade 3-4 study-related adverse events occurred in 5% and 6% of patients. Functional antigen-specific T cell responses could be detected in 67.1% of patients tested in the nDC treatment group vs 3.8% of patients tested in the control group (p < 0.001). In conclusion, while adjuvant nDC treatment in stage IIIB/C melanoma patients generated specific immune responses and was well tolerated, no benefit in RFS was observed.
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Affiliation(s)
- Kalijn F Bol
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Gerty Schreibelt
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Martine Bloemendal
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Wouter W van Willigen
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Simone Hins-de Bree
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Anna L de Goede
- Department of Pharmacy, Radboud university medical center, Nijmegen, The Netherlands
| | - Annemiek J de Boer
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Kevin J H Bos
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Tjitske Duiveman-de Boer
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Michel A M Olde Nordkamp
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Tom G M van Oorschot
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Carlijn J Popelier
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Jeanne M Pots
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Nicole M Scharenborg
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Mandy W M M van de Rakt
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Valeska de Ruiter
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Wilmy S van Meeteren
- Department of Dermatology, Radboud university medical center, Nijmegen, The Netherlands
| | - Michelle M van Rossum
- Department of Dermatology, Radboud university medical center, Nijmegen, The Netherlands
| | - Sandra J Croockewit
- Department of Hematology, Radboud university medical center, Nijmegen, The Netherlands
| | - Bouke J Koeneman
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Jeroen H A Creemers
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Inge M N Wortel
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
- Department of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | | | | | | | | | - Astrid A van der Veldt
- Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Dirk J van Grünhagen
- Department Surgical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Johanna E M Werner
- Department Surgical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Johannes J Bonenkamp
- Department Surgical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - John B A G Haanen
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marye J Boers-Sonderen
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Rutger H T Koornstra
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Oncology Center, Zwolle, The Netherlands
| | - Erik H J Aarntzen
- Department of Medical Imaging, Radboud university medical center, Nijmegen, The Netherlands
| | - Martin Gotthardt
- Department of Medical Imaging, Radboud university medical center, Nijmegen, The Netherlands
| | - James Nagarajah
- Department of Medical Imaging, Radboud university medical center, Nijmegen, The Netherlands
| | - Theo J M de Witte
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Carl G Figdor
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
| | - Johannes H W de Wilt
- Department Surgical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Johannes Textor
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
- Department of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | | | - Winald R Gerritsen
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - I Jolanda M de Vries
- Medical Biosciences, Radboud Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands.
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